BackgroundThe partial edentulous posterior mandible is often a challenge area that requires a bone reconstructive surgery for implants placement.PurposeThis RCT was aimed to evaluate complications rate and vertical bone gain after Guided Bone Regeneration (GBR) with dense non‐resorbable d‐PTFE titanium‐reinforced membranes (Group A) versus titanium meshes covered by cross‐linked collagen membranes (Group B).Material and Methods40 partially edentulous patients with atrophic posterior mandible, were randomly divided into two study group: 20 patients were treated with one stage GBR by means of non‐resorbable d‐PTFE titanium‐reinforced membranes (Group A); and 20 patients, by means of titanium mesh covered by cross‐linked collagen membranes (Group B). All complications were recorded, distinguishing between “surgical” and “healing” and between “minor” or “major.”. Primary implants stability and vertical bone gain were also evaluated.ResultsIn the group A, surgical and healing complication rates were 5.0% and 15.0%, respectively. In the group B, surgical and healing complication rates were 15.8% and 21.1%, respectively. No significant differences between two study group were observed regarding complications rate implant stability and vertical bone gain.ConclusionsBoth GBR approaches for the restoration of atrophic posterior mandible achieved similar results regarding complications, vertical bone gain and implant stability.

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Background One of the most recent innovations in bone augmentation surgery is represented by computer-aided-design/computer-aided-manufacturing (CAD/CAM) customized titanium meshes, which can be used to restore vertical bone defects before implant-prosthetic rehabilitations. The aim of this study was to evaluate the effectiveness/reliability of this technique in a consecutive series of cases. Methods Ten patients in need of bone augmentation before implant therapy were treated using CAD/CAM customized titanium meshes. A digital workflow was adopted to design virtual meshes on 3D bone models. Then, Direct Metal Laser Sintering (DMLS) technology was used to produce the titanium meshes, and vertical ridge augmentation was performed according to an established surgical protocol. Surgical complications, healing complications, vertical bone gain (VBG), planned bone volume (PBV), lacking bone volume (LBV), regenerated bone volume (RBV), average regeneration rate (RR) and implant success rate were evaluated. Results All augmented sites were successfully restored with definitive implant-supported fixed partial dentures. Measurements showed an average VBG of 4.5 ± 1.8 mm at surgical re-entry. Surgical and healing complications occurred in 30% and 10% of cases, respectively. Mean values of PBV, LBV, and RBV were 984, 92, and 892 mm 3 , respectively. The average RR achieved was 89%. All 26 implants were successfully in function after 1 year of follow-up. Conclusions The results of this study suggest that the bone augmentation by means of DMLS custom-made titanium meshes can be considered a reliable and effective technique in restoring vertical bone defects.

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Background: Guided bone regeneration (GBR) allows to achieve vertical ridge augmentation whether with nonresorbable membranes or resorbable membranes with Ti-mesh, but till now no studies are published comparing histological and histomorphometrical outcomes of these two procedures.Materials and Methods: Forty partially edentulous patients required vertical bone regeneration to place implants in the posterior mandible: 20 patients were randomly assigned to group A (Ti-PTFE); while 20 patients to group B (Collagen plus Ti-mesh).For both groups, graft material was a 50:50 mixture of autogenous bone and bone allograft. After 9 months, tissue biopsies were taken from augmented sites (regenerated bone ROI-1; native bone ROI-2) and undergone to histological and histomorphometric analysis. Percentages of bone tissue (B.Ar), biomaterial (Mat. Ar), and soft tissue (St.Ar) were measured; measurements of perimeters were calculated too. ROI-1 values were also compared to ROI-2 in both groups.Results: Twenty-five samples were collected and analyzed consecutively: 13 in group A and 12 in group B. The mean B.Ar, Mat.Ar, and St.Ar were 39. 7%, 8.6%, and 52.1% in group A; similar results were obtained in group B, with mean values of 42.1%, 9.6%, and 48.3%, respectively. No significant statistically differences were observed.Differences were observed between ROI-1 and ROI-2 in both group. Finally, bone structure index of ROI-1 and ROI-2 showed statistical differences. Conclusions:The preliminary results of this study suggest that GBR using nonresorbable membranes and Ti-mesh with resorbable membranes in combination with autogenous bone and bone allograft provide similar histological and histomorphometric results. K E Y W O R D Sbone augmentation, bone defects, histological analysis

ObjectivesThe aim of this study was to evaluate hard and soft tissues around implants placed in posterior mandible 1 year after vertical ridge augmentation (VRA).Materials and Methods40 patients with vertical defects were enrolled and treated according to the study protocol. Patients were randomly divided into two study groups: reinforced PTFE membranes (group A) and titanium meshes plus collagen membranes (group B). All patients received simultaneous implants which were evaluated after prosthetic restoration at baseline and after 1 year, using the following parameters: peri‐implant bone levels (PBLs), interproximal bone peaks (IBPs), pocket probing depth (PPD), bleeding on probing (BoP), plaque index (mPI), gingival index (mGI), keratinized tissue thickness/width (tKT and wKT), and fornix depth (FD). Statistical analysis was performed to investigate any statistically significant differences and/or correlations (p = .05).Results30 patients were completely followed up according to the study protocol. After 1 year, implants showed a change in PBL from 0.12 to 0.76 mm, with marginal bone loss of 0.67 and 0.61 mm for group A and group B, respectively, without significant differences (p > .9337). The estimated difference between treatments for the change from baseline in PBL was −0.05 (95% CI −0.27 to 0.16). Statistical analysis revealed strong correlations between PBL and IBP (p < .0001). However, no significant differences were observed for PPD, mPI, mGI, tKT, wKT, and FD (p > .05).ConclusionThe results indicate that GBR treatment with titanium meshes plus collagen membranes (Group B) compared to reinforced PTFE membranes does not appear to be inferior or superior in terms of PBL change. In both groups, hard and soft tissues were stable after 1 year of follow‐up, with a peri‐implant bone loss less than 1.0 mm in the first year (study registered at ClinicalTrials.gov NCT04332679).

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Purpose To evaluate the survival, success, and complication rates of tapered double-lead threads single implants, placed in fresh extraction sockets and healed sites of the posterior jaws. Methods The enrolled patients were randomly divided into 2 groups: in the test group (TG), all implants were inserted at the time of tooth extraction; in the control group (CG), all implants were placed 3 months after extraction. The implants were followed for a period of 1 to 3 years after loading. The main outcomes were implant survival, complications, and implant-crown success. Results Ninety-two patients had 97 installed implants (49 in the TG, 48 in the CG). Only two implants failed, in the TG; the survival rates were therefore 95.9% (47/49) and 100% (48/48) for TG and CG, respectively. In the surviving implants, no complications were reported, for an implant-crown success of 100%. Conclusions Although a significant difference was found in the levels of primary stability between TG and CG, single implants placed in fresh extraction sockets and healed sites of the posterior jaws had similar survival and complication rates. Crestal bone levels and peri-implant bone resorption showed similar values. A longer follow-up period is however required, to confirm these positive outcomes.